Renal failure, acute patient history

CDC Case Definition A mosquito-borne viral illness characterized by acute onset and constitutional symptoms followed by a brief remission and a recurrence of fever, hepatitis, albuminuria, and symptoms and, in some instances, renal failure, shock, and generalized hemorrhages. Laboratory criteria for diagnosis is (1) fourfold or greater rise in yellow fever antibody titer in a patient who has no history of recent yellow fever vaccination and cross-reactions to other flaviviruses have been excluded or (2) demonstration of yellow fever virus, antigen, or genome in tissue, blood, or other body fluid. 

Renal function impairment Renal impairment, including cases of acute renal failure and Fanconi syndrome, has been reported in association with the use of tenofovir. Avoid tenofovir with concurrent or recent use of a nephrotoxic agent. Carefully monitor patients at risk for, or with a history of, renal dysfunction and patients... 

In the first patient and the fourth patient in our initial series (p. 7), the association of ALPE with anaerobic exercise had not yet been recognized, and their medical histories may have been insufficient, or the patients may not have reported intense exercise over a short duration. In acute renal failure patients with loin pain of unknown etiology, the presence or absence of anaerobic exercise should always be ascertained when taking their medical history. Erley et al. [28] did not comment on exercise in their study. However, when Sato et al. inquired about exercise in 1998 [34], Erley et al. reported that the patient had undertaken exercise. 

A previous medical history of non-insulin dependent diabetes mellitus and hypertension are added risk factors for developing acute renal failure, as they will predispose the patient to having a degree of chronically impaired renal function. 

Patients at risk for SRMB include those with respiratory failure (need for mechanical ventilation for >48 hours), coagulopathy, hypotension, sepsis, hepatic failure, acute renal failure, multiple trauma, severe burns (>35% of body surface area), head injury, traumatic spinal cord injury, major surgery, or history of GI bleeding. " ""... 

A number of reports in the mid to late 1980 s described patients who developed rhabdomyolysis while using cocaine [118-120]. Some of these patients experienced acute renal failure [121-125]. While the exact incidence of acute renal failure secondary to cocaine rhabdomyolysis is unknown, in one reported series it occurred in only three of 211 admissions for cocaine related complications [114]. On the other hand, in another series of nearly 40 patients the incidence of cocaine related acute rhabdomyolysis increased over the period of enrollment from 2 patients in 1985 to 22 patients in 1987 [126]. Several reports of patients with cocaine-induced rhabdomyolysis have clearly defined both the clinical syndrome and the risk factors for the development of acute renal failure and an adverse outcome [123, 126, 127]. Most patients have been previously healthy young males (mean age 30-35 years old and 80-85% male). The cocaine has been smoked, used intravenously, snorted, or taken orally implying that route of administration was not relevant [122,123,126, 127]. In contrast to narcotic related rhabdomyolysis, a history of prolonged coma or stupor is absent. On presentation, the majority of patients are combative and... 

IV. Diagnosis. A syndrome beginning with severe gastroenteritis, leucocytosis, shock, rhabdomyolysis, and acute renal failure and, several days later, leukopenia and thrombocytopenia should suggest colchicine poisoning. A history of gout or familial Mediterranean fever in the patient or a family member is also suggestive. 

Acute renal failure caused by rhabdomyolysis resulting from tonic clonic seizures was reported in a man who ingested 10 ml of wormwood essential oil. The patient had no history of neuromuscular disease, kidney disease, or history of alcohol dependence. The manufacturer confirmed that the wormwood essential oil consumed was pure and not adulterated (Weisbord et al. 1997). Ingestion of 60 ml of wormwood essential oil led to altered mental status, seizures, and secondary complications including hyperthermia, rhabdomyolysis, and aspiration (Berlin and Smilkstein 1996). 

When an acute stroke patient is imaged within the therapeutic window, we usually do not wait for the results of creatinine testing, except in case of known history of renal failure or prior serum creatinine measurement that exceeded 1.5 mg/dl, known renal disease, sohtary kidney (e.g., prior nephrectomy, congenital absence), diabetes melhtus (insuhn-dependent >2 years or non-insulin dependent >3 years), collagen vascular disease (e.g., lupus), or paraproteinemia syndromes (e.g., myeloma). This approach has been demonstrated as safe in more than 1,000 patients, with only a very low rate of temporary renal failure (0.19%) and no case of permanent renal failure (Josephson et al. 2005). 

A 26-year-old woman, hospitalised for exacerbation of acute intermittent porphyria, who had a history of hypertension and chronic renal failure, developed hyperpotassaemia (6.7 mPq/L potassium) in the hospital. She was given an intravenous infusion oflOmL calcium gluconate, bullous skin reactions occurred in the infusion area nearly 2 h after administration. Clinicians must be prepared for rare possibility of bullous skin reactions, which may be a predictor of extravasation and necrosis, when treating patients with intravenous calcium gluconate [73 ]. 

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